Publications by authors named "Matthew F Kalady"
Background: Gastrointestinal (GI) distress is prevalent and often persistent among cancer survivors, impacting their quality of life, nutrition, daily function, and mortality. GI health screening is crucial for preventing and managing this distress. However, accurate classification methods for GI health remain unexplored.
View Article and Find Full Text PDFBackground: Colorectal cancer (CRC) patients experience multiple types of chemotoxicity affecting treatment compliance, survival, and quality of life (QOL). Prior research shows clinician-reported chemotoxicity (i.e.
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- Gastrointestinal (GI) cancers have high incidence and mortality rates, and social media platforms like Twitter are being used to share health-related information effectively.* -
- A study analyzing over 87,000 tweets revealed key public discussions regarding GI cancer prevention, risk factors related to lifestyle (mainly diet), and survivorship care, with specific themes varying by cancer type.* -
- The findings highlight the importance of personalized management of GI cancers and suggest that Twitter data can aid in understanding public concerns, ultimately guiding future research and patient care strategies.*
Article Synopsis
- The study investigated how health-related quality of life (HRQoL) among colorectal cancer (CRC) survivors varies by race and ethnicity, focusing on disparities and the influence of social determinants of health (SDOH).
- Using data from 2,492 adult CRC survivors, the research revealed that non-Hispanic Blacks and Hispanics reported worse HRQoL compared to non-Hispanic Whites, with factors like unemployment and low income contributing to this disparity across all groups.
- The findings underscore the importance of developing tailored interventions that address social and financial barriers to improve HRQoL for marginalized CRC survivors.
Management of Rectal Cancer in Lynch Syndrome: Balancing Risk Reduction and Quality of Life.
Clin Colon Rectal Surg
May 2024
Article Synopsis
- Patients with Lynch syndrome have a higher risk of developing colorectal cancer and other cancers at a younger age, requiring specialized management.
- The management of rectal cancer in these patients involves complex decisions such as whether to perform proctectomy alone or total proctocolectomy, and the use of chemotherapy, immunotherapy, and nonoperative options.
- The review emphasizes balancing cancer risk reduction with improving patients' quality of life in treatment decisions.
Article Synopsis
- Malnutrition negatively impacts healthcare outcomes, but the influence of food environments on surgical recovery, specifically for colorectal cancer (CRC), has not been thoroughly explored.
- A study analyzed over 260,000 CRC surgical patients, linking their data to food environment information, revealing that those in unhealthy food environments had lower chances of achieving optimal postoperative outcomes, or "textbook outcomes."
- Findings suggest that living in unhealthy food environments—marked by high social vulnerability and minority representation—could be a significant factor in postoperative disparities, highlighting the need for addressing food access as part of healthcare improvements.
Background: Left-sided colorectal surgery demonstrates high anastomotic leak rates, with tissue ischemia thought to influence outcomes. Indocyanine green is commonly used for perfusion assessment, but evidence remains mixed for whether it reduces colorectal anastomotic leaks. Laser speckle contrast imaging provides dye-free perfusion assessment in real-time through perfusion heat maps and quantification.
View Article and Find Full Text PDFBackground: Food insecurity predisposes individuals to suboptimal nutrition, leading to chronic disease and poor outcomes.
Objective: We sought to assess the impact of county-level food insecurity on colorectal surgical outcomes.
Design: Retrospective cohort study.
Article Synopsis
- The study aimed to evaluate prognostic factors for colorectal gastrointestinal stromal tumors (CR GISTs), which are rare and their management is debated.
- A retrospective review of 56 patients who underwent surgery at a center from 2002 to 2019 found that R0 resection and perioperative imatinib treatment improved recurrence-free survival (RFS) in high-risk patients.
- In rectal GIST cases, R1 resection was linked to poorer RFS, and while perioperative imatinib helped recurrence rates, it did not affect overall survival (OS).
Article Synopsis
- Colorectal cancer (CRC) survivors often face cognitive impairment and various symptoms post-treatment, but there's limited knowledge about the risk factors influencing these complex symptom patterns.* -
- The study identified three groups of CRC survivors based on symptom profiles: one with low symptoms, one with high psychological symptoms like depression and anxiety, and another with high somatic symptoms (fatigue, sleep issues, and pain) along with cognitive impairment.* -
- Findings indicate that those with a high symptom burden tend to have a shorter time since diagnosis, higher perceived stress, and poorer emotional social support, highlighting the need for better screening and targeted interventions for these issues.*
Article Synopsis
- Real-time tissue perfusion measurement using Laser Speckle Contrast Imaging can enhance surgical decision-making by revealing ischemic changes in the intestines due to blood flow obstruction.
- In a study with porcine models, the technique effectively distinguished between well-perfused and ischemic bowel segments under various occlusion scenarios.
- Results showed a strong correlation between perfusion measurements and blood pressure changes, demonstrating that Laser Speckle could be used to assess and compare perfusion in different intestinal anastomosis techniques.
Article Synopsis
- * A study of 165 patients showed a rising incidence of pouch adenomas over time, with 28.5% of patients diagnosed, but none progressed to cancer throughout the follow-up period.
- * The research created a classification system for polyposis severity based on the size, number, and histology of the adenomas, indicating that progressive monitoring is important for managing patient outcomes.
Multimodality treatment for locally advanced rectal cancer is the standard of care. Treatments include surgery, radiation, and chemotherapy, with medical therapies now being favored in the neoadjuvant setting. Various regimens continue to be studied and defined in prospective randomized trials.
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- Colorectal cancer (CRC) survivors, especially women, often deal with persistent gastrointestinal (GI) symptoms long after treatment, with 81% reporting ongoing issues such as bloating, constipation, and abdominal pain.
- Significant risk factors for these symptoms include the time since diagnosis, cancer stage, psychological distress, poor diet, and low physical activity, with fatigue and sleep disturbance having the highest impact.
- The findings indicate a strong correlation between severe GI symptoms and low quality of life, urging the need for better survivorship care and policies aimed at improving the overall well-being of CRC survivors.
Background: Lynch syndrome has not traditionally been considered to have a high colorectal adenoma burden. However, with increasing adenoma detection rates in the general population, the incidence of adenoma detection in Lynch syndrome may also be increasing and leading to higher cumulative adenoma counts.
Aim: To clarify the prevalence and clinical impact of multiple colorectal adenomas (MCRA) in Lynch syndrome.
Background: We hypothesized that prolonging the interval to surgery in non-responders to neoadjuvant chemoradiation therapy (nCRT) could lead to worse oncologic outcomes.
Methods: Rectal adenocarcinoma patients with poor tumor response to nCRT (AJCC tumor regression grade 3) were selected. Oncologic outcomes were evaluated according to the time interval between completion of nCRT and surgery.
Incidence and prevalence of advanced colorectal neoplasia in Lynch syndrome.
Gastrointest Endosc
September 2023
Article Synopsis
- Lynch syndrome (LS) is the leading hereditary cause of colorectal and endometrial cancer, with varying effectiveness of colonoscopy for preventing colorectal cancer in affected individuals.
- A study involving 132 LS patients examined neoplasia during surveillance colonoscopies, finding prevalent advanced adenomas in 10.7% of patients and incident cases in 6.1%, with invasive colorectal cancer occurring in a very small percentage.
- Results indicate that advanced neoplasia is rare during annual surveillance in U.S. LS populations, with invasive cancer predominantly found in specific genetic variant carriers, suggesting further research is needed to validate these observations.
Article Synopsis
- - The study examines how changes in the viral microbiome, particularly bacteriophages and eukaryotic viruses, are linked to the development and progression of Crohn's disease (CD), highlighting the importance of gut microbiome dysbiosis.
- - Researchers analyzed stool samples from both healthy individuals and CD patients during flare-ups and remission, finding significant changes in the diversity and composition of the virome and its correlation with the disease status.
- - Key findings included an increase in specific viruses, like the Torque teno virus and disease-related phages, during flare-ups, and the potential for virus-bacteria interactions and viral functions to serve as biomarkers for diagnosing CD and understanding its pathogenesis.
Article Synopsis
- A multidisciplinary group of 69 experts created the first evidence-based consensus recommendations for managing early-onset colorectal cancer (eoCRC) since existing guidelines are not age-specific.
- They utilized a Delphi methodology, achieving an 80% consensus on 31 important statements covering diagnosis, genetics, therapy, and more, emphasizing the need for risk stratification and genetic testing for patients under 50.
- The recommendations highlight that treatments for eoCRC should generally align with those for later-onset cases, but also point out knowledge gaps that require further research, including optimal screening age and post-treatment care.
Universal tumor screening (UTS) for Lynch syndrome (LS) on colorectal cancer (CRC) can be performed on biopsies or resection specimens. The advantage of biopsies is the chance to provide preoperative genetic counseling/testing (GC/T) so patients diagnosed with LS can make informed decisions regarding resection extent. We evaluated utilization of UTS on biopsies, percentage of patients with deficient mismatch repair (dMMR) who underwent GC/T preoperatively, and whether surgical/treatment decisions were impacted.
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- About 5% of colorectal cancers are linked to inherited syndromes with specific genetic causes, which significantly elevate risks for both colorectal and other cancers.
- Identifying these genetic variants helps in risk assessment and guides personalized treatment plans, impacting surgical decisions like the timing and type of surgery needed.
- Familial Adenomatous Polyposis (FAP) and Lynch syndrome are two key inherited conditions where interventions such as prophylactic surgeries are tailored based on individual genetic profiles and cancer risks.
Article Synopsis
- * Hereditary colorectal cancer syndromes are categorized into nonpolyposis and polyposis conditions, each with specific characteristics.
- * Nonpolyposis conditions are split between those causing tumors with defective mismatch repair and those that do not, while polyposis conditions are classified based on their histological features.
Article Synopsis
- About 5% of colorectal cancers are linked to hereditary syndromes, increasing the risk of early-onset colorectal and other cancers in patients and their families.
- Identifying and diagnosing these hereditary syndromes is essential for effective management and reducing cancer risk.
- Surgeons need to understand the specific surgical approaches for hereditary syndromes, especially for Lynch syndrome and familial adenomatous polyposis, to optimize treatment.